Healthcare Provider Details

I. General information

NPI: 1447474713
Provider Name (Legal Business Name): LINDA HITTLEMAN M.S.,R.D.,C.D.C.E.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 02/08/2025
Certification Date: 02/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2373 BROADWAY APT 825
NEW YORK NY
10024-2835
US

IV. Provider business mailing address

95 CLAYTON AVE
EAST ATLANTIC BEACH NY
11561-1006
US

V. Phone/Fax

Practice location:
  • Phone: 516-971-1377
  • Fax:
Mailing address:
  • Phone: 516-971-1377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: